Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111	
	MassHealth
	Pharmacy Bulletin 59
	August 1999

	TO:	Pharmacies Participating in MassHealth

	FROM:	Mark E. Reynolds, Acting Commissioner

	RE:	New Address for Prior Authorization Requests for Drugs

Background	In the continuing effort to manage the pharmacy program in a clinically appropriate and cost-effective manner, the Division of Medical Assistance (“the Division”) is contracting with the University of Massachusetts Medical School (“UMass”) to process all prior authorization requests for drugs, including those drugs that are administered in the physician’s office.  UMass currently administers the Drug Utilization Review Program for the Division. 

New Address	Effective 9/6/99, submit requests for all injectable, infusable, and oral 
for  PAs for 	drugs or biologicals (such as Hyalgan) that require prior authorization to 
Drugs Only	the following address.

University of Massachusetts Medical School 
DUR Program Offices
11 Midstate Drive
Auburn, MA 01501

Telephone:	(508) 721-7171
Fax:	(508) 721-7138 

NOTE:  Send only prior‑authorization request for drugs, including Hyalgan, to UMass. 

PA Procedures	Prior authorization for drugs and biologicals dispensed by a pharmacy
for Drugs	must be requested by the prescribing provider.  The prescribing provider 
Dispensed by	must complete a Request for Prior Authorization form or submit a written 
a Pharmacy	request on his or her letterhead containing the information required in 
the billing instructions in Subchapter 5 of his or her provider manual.  The request must include the name, address, and telephone number of the pharmacy that will fill the prescription.

										

Supplies of the	To obtain supplies of the Request for Prior Authorization form, mail or fax 
PA Form	a written request to the following address or fax number.

Unisys
ATTN: Forms Distribution
P.O. Box 9101
Somerville, MA  02145
Fax:  (617) 576-4087

Questions	If you have any questions about the information in this bulletin, please contact the Unisys Provider Services Department at (617) 628-4141 or 1-800-325-5231.